Vitamin D plays an important role in forming and maintaining strong bones. Research has shown that it has direct or indirect control over more than 200 genes, and vitamin D receptors exist in most of your body tissues. Although research on vitamin D is moving beyond its effect on the skeletal system, it is still your bones that show the most visible symptoms of vitamin D deficiency.
The Basics
Vitamin D deficiency is defined as levels of 25-hydroxyvitamin D of less than 30 ng per milliliter of blood, according to the 2007 review article "Vitamin D Deficiency" published in the "New England Journal of Medicine." Vitamin D intoxication, or an overdose of vitamin D, occurs with blood levels of greater than 150 ng per milliliter. Using these values, researchers estimate that 1 billion people worldwide have vitamin D deficiency, including between 40 and 100 percent of elderly men and women in the United States.
Rickets
Vitamin D deficiency in a pregnant woman can prevent the baby's skeleton from incorporating the maximum amount of calcium. If the vitamin D deficiency continues into childhood, it can lead to rickets, a softening of the child's bones. Symptoms of rickets include bone pain or tenderness to touch, bowed legs, spinal curvatures, short stature and weak teeth. Your doctor may prescribe supplements for breastfed babies to ensure that they receive enough vitamin D.
Osteomalacia, Osteopenia and Osteoporosis
Without vitamin D, your body can absorb only between 10 and 15 percent of the calcium from your diet, and only 60 percent of the phosphorus. If your diet lacks vitamin D, the density of these minerals in your bones is severely impaired. Vitamin D deficiency in adults can cause osteopenia, a less-than-healthy bone density. If the deficiency persists, the loss of bone density may progress to osteoporosis -- increasing your risk of bone fractures. The imbalance of calcium and phosphorus created by vitamin D deficiency can also cause osteomalacia. This is a softening of the bones comparable to rickets, but seen in adults. Symptoms of osteomalacia include throbbing, aching pain in the bones. Moderate pressure on the sternum or lower leg can cause bone pain, similar to the pressure point pain seen in fibromyalgia.
Secondary Hyperparathyroidism
When levels of vitamin D drop, so does blood calcium levels. This in turn increases blood levels of parathyroid hormone, resulting in hyperparathyroidism secondary to vitamin D deficiency. The parathyroid hormone activates osteoclasts, cells that dissolve bone to release calcium in an effort to restore the calcium balance in the blood. Symptoms of secondary hyperparathyroidism include swollen joints, bone pain and increased bone fractures. When the cause of secondary hyperparathyroidism is vitamin D deficiency, treatment includes supplementation with vitamin D.
Hypophosphatemia
The increase in parathyroid levels caused by vitamin D deficiency can lead to hypophosphatemia, low levels of phosphorus in the blood. Symptoms include bone pain, confusion and muscle weakness that can lead to difficulty breathing or heart muscle damage. Treatment for hypophosphatemia includes supplementing the diet with oral phosphorus or giving the patient a phosphorus solution by intravenous line.
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